NCG190018 DMR SW (15)

(
STORMWATER DISCHAItGE OUTFALL(SDO)
GENERAL PERMIT NO.NCG190000
DISCHARGE MONITORING REPORT(DMR)
SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTIFICATE OF COVERAGE NOt,. .111/) (This monitoring report is due at the Division no later than 30 days from
t e the facility receives the sampling results from the laboratory.)
FACILITY NAME eR�•t?Y-Wiirr -A:4-,.., h -, ,- COUNTY Pi A
PERSON COLLECTING SAMPLES Ti4MES E HARDLv PHONE NO.(2S1 )752-2.11/
' CERTIFIED LABORATORY tln4Rav* ,r d-- Lab# JUN 1 6 2W6
Lab#
CENTRAL FILES
Part A: Specific Monitoring Requirements ONA/R SECTION
Outfall Date 00530- 00400 00556 „ 01119 01104 01094 01114
No. Sample Collected, Total Rainfall, Total Suspended ' pH, Oil'&Grease, Copper2'3, Aluminum2 Zinc2'3, Lead'3,
mo/dd/yr inches Solids,mg/L Standard units ,mg/L mg/L ,mg/L mg/L mg/L
Benchmark' - - 100 Within 6.0—9.0 30 0.007 0.75 0.067 0.03
I- F 5 ri 16 0.•201' 15 7.2 z.5,O .i-o.oi 0 0,a 7 0.7 4.O,ouS
'If a value is in excess of the benchmark,or outside the benchmark range(for pH),you must implement the Tier 1 or Tier 2 responses in the General Permit.
2 Total recoverable
3 These benchmarks are water hardness dependant. Values shown based on a hardness of 50 mg/L.
Solvent Management Plan Certification:
Mail original and one copy to: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit requirement
Division of Water Quality for managing solvents,I certify that to the best of my knowledge and belief,no leak,spill,or dumping of concentrated
Attn:Central Files solvents into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since filing the
1617 Mail Service Center last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Raleigh,North Carolina 27699-1617 Management Plan included the Stormwater of . ion Prevention Plan."
e I • 67./5-76
: ;nature of Permittee) (Date)
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION ,'PORTED:
"I certify,under penalty of law,that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or
persons who manage the system,or those persons directly responsible for gathering the information,the information submitted is,to the best of my
knowledge and belief,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,including the
possibility of fines and imprison ent for knowing violations."
a 9NI
s).....___
(Signature of rmittee) (Date)
Permit Date: 10 1 2009-9/30/2014
SWU-253-092309
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